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181 Cards in this Set
- Front
- Back
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What cytokines are induced by the Teichoic Acid in a GRAM POSITIVE membrane?
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-IL-1= fever
-TNF -----VS---- GRAM POSITIVE= Lipid A |
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Where are the Beta-Lactamases stored in a GRAM NEGATIVE bacteria the allows them to escape B-Lactam antibiotics?
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Periplasm
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Which is the only Capsule that is NOT made from Polysaccharides?
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Bacillus Anthracis= D-glutamate
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What is the SPORE made from that makes it very resistant to heat, dehydration, chemicals?
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Di-picolinic acid
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What allows bacteria to bind to surfaces?
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1. Glycocalyx =made from polysaccharide
-------- 2. IgA Protease= "PiGM" -S. pneumoniae -H. influenzae -N. Gonorrhea -N. meningitidis |
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What bugs will you not see with a GRAM STAIN?
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-Treponema= need Darkfield + fluorecence
---- -Rickettsia/legionella/chlamydia= inside cells ***use Silver stain for legionella ----- -Mycobacterium= too much lipids on wall= need ACID FAST STAIN ------- -Mycoplasma= NO cell wall |
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What is occurring in the different stages of the the bacterial growth curve?
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Lag= metabolic activity
Log= cell division Stationary= out of food= slow growth Death= too much waste products |
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What type of toxins do GRAM NEGATIVE bacteria have?
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Exotoxin [peptide] + Endotoxin [Lipo/sugar]
---VS---- Gram Positive= only EXOtoxin ----- Dangerous at LOW dosages= EXOtoxins ---- EXO= Tetanus, Botulism, Diphtheria = induce high-titer anti-toxins (antigenicity) |
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What is the only SECRETED EXOtoxin that is NOT destroyed by HIGH Temperatures?
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Staph= ENTEROtoxin = because they are detected by Ab you can use toxoids as vaccines
----VS---- most ENDOtoxins are sable at HIGH temperatures = IL-1/TNF= NOT secreted or detected by Ab's in the body => fever/shock=> meningococcemia ----- Techoic Acid(+) and LPS(-)= ENDOtoxins |
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What type of antigen causes LARGE amounts of IFN-gamma + IL-2 by activating T-cells (via binding to TCR + MHC-II)?
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SUPERantigens from:
1. Staph a. => -TSST-1= fever + rash + shock -Enterotoxins= food poisoning ------------- 2. Strep. pyogenes -Scarlet Fever= kinda like toxic shock |
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What bugs use the ADP ribosylating AB Toxin?
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EXOtoxins=
B= attaches to cell A= ADP Ribosylation= alters function=> ------------ -Diphtheria: blocks EF-2=> pharyngitis + pseudomembrane in throat ----------- -Cholerae: cAMP=> secretes Cl- in GI = rice water diarrhea --------VS------- -E. Coli: cGMP=> watery diarrhea (toxin can resist heat) -------------- -Bordetella Pertussis: cAMP= Whooping cough + increases lymphocytes |
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Which two bacteria release SHIGA TOXIN= destroys the host's rRNA, causes release of cytokines= HUS?
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1. Shigella,
2. E. Coli= O157:H7 |
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What is the main EXOtoxin with these bugs?
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Clostridium Perfringens= alpha toxin=GAS gangrene= double zone of hemolysis on blood agar
-------------- C. tetani= blocks release of Glycine= lock Jaw + floppy baby ------- C. Botulinum= spores in honey= blocks ACh release ---------- S. pyogenes= Streptolysin O= ASO Ab target= rheumatic fever |
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What are the different ways that ENDOtoxin Lipid A works?
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Macs=>
IL-1(fever), TNF(fever,hermorrhagic tissue necrosis), NO(hypotension) ------- Compliment=> C3a(hypotension), C5a(PMN) -------- Hageman Factor=> DIC |
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What is HUS?
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Hemolytic Uremic Syndrome= hemolytic anemia, renal failure, lowers platelets
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The Nisseria Family ferment different sugars. What are they?
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Only Glucose= Gonococci
---------VS------ Glucose/Maltose= MeninGococci |
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Which bugs produce pigment that allows indentification?
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Yellow= staph a. -------VS----- Green= Pseudomonas ---VS---- Red= Serratia marcescens
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Gram Stain
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Positive= Purple
-------VS------- Negative= Pink |
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What does catalase positve mean?
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Posses Catalase which breaks down H2O2
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How do the various Streptococci react to blood?
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Change color via hemolysis:: Green= S. pneumonia + viridians streptococci
----VS--- Clear= S. Pyogens + S. agalactiae ----VS--- no hemolysis= Enterococci= E. faecalis |
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Which GAS is sensitive to optochin and soluble in bile ?
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S. Pneumonia
----VS---- viridians which is not |
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Which GBS is sensitive to Catalase and Bacitracin?
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S. pyogens
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Which are some GRAM POSITIVE bugs that are not Cocci BUT RODS?
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Clostridium, Bacillus, Listeria
----- Which one cannot live with O2? Clostridium |
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How do you differentiate between Gram NEGATIVE Cocci?
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N. Gonorrhoeae is NOT able to ferment MALTOS
-----VS------ N. meningitidis which can |
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Among the Gram NEGATIVE RODS that can ferment Lactose which ones are FAST vs. SLOW?
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FAST= Klesbiella + E. Coli
------VS----- SLOW= Serratia (red pigment) |
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Among the GRAM NEGATIVE RODS that CANNOT ferment LACTOSE but CAN use oxygen becaue they have cytochrome c oxidase (=oxidase positive in test)?
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Pseudomonas
-----------VS-------- Do NOT have Oxidase= Shigella, Salmonella, Proteus |
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What would you use to plate H. influenza [-/CR]?
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V(NAD) and K(hematin) factors in chocolate agar
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What would you use to grow N. Gonorrheae[-/C]?
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TM media
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What would you use to grow Bordatella[-/CR]?
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BG = potato agar
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What would you use to grow Diphtheria[+/R]?
**one of the [+R= CBLD] *** |
hats O2= Tellurite plate with Loffler's medium and blood
----- contains METACHROMATIC GRANULES and looks like a club ---- Toxins come from Beta-prophage--> block ADP-Rybosylation of EF2=> cause Pseudomembranous Pharyngitis w/ large lymphnodes -------VS---- Clostridium DIFFICILE= Pseudomembranous COLITIS |
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What would you use to grow Mycobacteria Tuberculosis[AF]?
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Lowenstein-Jensen agar
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How can you grow enterics that can fermentate Lactose like enterobacteria[-/R/L]= also Kleb/E.coli?
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MacConkey= turn PINK
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How would you grow Legionella to verify diagnosis?
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Charcoal yeast with a lot of Fe++ and CYSTEINE
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In what type of medium does FUNGI grow on?
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Sabouraud's
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What are some special stains used to identify cellular components and bugs?
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Congo Red= Amyloid= turns apple-green= Beta sheets
---- Giemsa= Borellia, plasmodium, trypanasomes, chlamydya= stains DNA----- PAS= glycogen, mucopolysaccharides= diagnose Whipple's Disease(#1 mal-abs) ------ Ziehl-Neelson= Acid-Fast bacteria ----- India Ink= Cryptococcus neoformis= yeast(AIDS) -------- Silver Stain= Fungi/PCP/legionella |
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What are the only methodes EUKARYOTIC cells can change their genetic makup?
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1. Transformation (picks up pure DNA)
2.TRANSPOSITION= jumping genes= one chromosome to another= does not leave cell -----------VS------- methods involving pathogen invasion=> 1. Transduction= phage -------VS----- only prokaryotes= sex pillus= conjugation |
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Which types of bacteria carry their toxin via genetics I.e. they need the host in order to make it (LYSOGENY)?
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Botulinum, Cholera, Diphtheria, S. pyogenes (erythrogenic toxin)
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Where do you see obligate aerobes= they NEED O2 to live?
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Apex of the lungs= highest O2= Mycobacterium Tuberculosis
------ Burn wounds + airways= exposed to O2= Pseudomonas a.=> cause of pneumonias ------ Also in this group: Nocardia, Bacillus[+/R] |
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Which bugs cannot be killed by Aminoglycoside (need O2 to enter cell) because bugs are obligate ANAerobes = hate O2?
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Clostridium, Bacteroides, Actinomyces= live in GI= cannot deal with O2 derived free radicals because they do not have: SOD/Catalase => produce gas (CO2/H2) + smell bad because of the short-chain FA
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What bugs CANNOT make their own ATP and thus MUST live inside cells who do?
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Rickettsia + Chlamydia
------VS------- Facultative ones= Legionella, [Francisella, Yersenia, Brucella] Niserria[-/C], Salmonella [-/R], mycobacteria[AF] --- only + is Listeria [+/R] |
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Which bugs because they are ENCAPSULATED allow us to create vaccines without the bad response?
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H. influenzae= TYPE B
----- N. meningitidis= meningiococcal vaccines ---- S. pneumonia= PNEUMOVAX= quellung reaction is positive because of capsule= swells up |
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Which bugs are the only ones that form SPORES(dipicolinic acid + no metabolism) when no food is available and thus require instruments to be AUTOCLAVED?
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[+/R]=>
1. Bacillus (anthrax), ----------------- 2. Clostridium= hate O2=> -perfringens= alpha toxin= necrosis of muscle, gas gangrene, hemolysis -difficile= kills enterocytes= pseudomembranous colitis= after Clindamycin/ampicillin use= Tx: metronidazole -botulinum= blocks ACh release=flaccid paralysis in babies ---VS--- -tetani= blocks glycine release= paralysis |
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Which is the only +/R that shows tumbling motility and the source of newborns with meningitidis typically from unpasturized milk?
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LISTERIA also happens to be BETA-hemolytic= clear
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What bug is escapes from the myeloperxidase system by destroying what it needs?
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Staph because they have Catalase which breaks up the substrate for the myeloperoxidase system= H2O2
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What type of toxins are associated with Staph. a.?
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Protein A= binds to the Fc portion of the IgG=> prevents compliment activation + phagocytosis of the bacteria:
------- Results in two different disease pathways: 1. Inflammatory Disease= skin infections, abscess, pneumonia ------- 2. Toxic Diseases= Toxic shock syndrome, scalded skin syndrome, rapid food poisoning (pre-formed toxin) |
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How are you able to detect a RECENT Strep. Pyogenes infection?
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ASO titer
---------- What is advantageous to our defense systems regarding S. pyogenes? -We can attack its M Protein |
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What kind of diseases are caused by the GBS?
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-Pyogenic= pharyngitis + cellulitis + impetigo
-Toxigenic= scarlet fever, TSS, -Immune: rheumatic fever, acute GN |
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What bug is responsible for the MOST COMMON presentation of:
Meningitis in Kid Otitis Media in kids Pneumonia= rust color sputum Sinusitis? |
Streptococcus Pneumonia
------- also the cause of sepsis with sickle cell anemia ------VS----- meningitidis + NEWBORN= Listeria |
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How would you determine the cause of a UTI or subendocarditis caused by the GGB[+R/Gamma]?
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Only Enterococci can survive 6.5% NaCl
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What commonly infects prosthetics and lab cultures?
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Staph. Epidermidis = normal flora of skin
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What Bug causes Tooth caries + subacute endocarditis?
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GAS= Viridans which include:
mutans= teeth anguis= valves |
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What are some indications that an individual has Bacillus Anthracis [+R]?
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-contact with WOOL--> painless ulcer--> BLACK Eschar --> death from bacteremia
----VS----- Woolsorter's Disease= inhalation of SPORES= flu --> FEVER, Lung hemorrhage, Shock ----------------- only Spore that has a PROTEIN CAPSULE |
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What 2 bacteria bugs look like FUNGI but are NOT?
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[+R] ==>NO SPORES==>form Branches:
1. Actinomycis = SULFER GRANULES= facial abscess/sinus=> Penicillin ------VS------ 2. Nocardia= AIDS= lung infection => Sulfa drugs |
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Why are Gram Negative bugs not killed by Penicillin G or even Vancomycin?
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Outer wall prevents entry of drugs==> try Ampicillin
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Which gram negative bug causes NEONATAL conjunctivitis because an infection from the mother during a vaginal birth?
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Nisseria Gonococci= gonorrhea infection=>
----- No vaccine available because it DOESNOT have a polysaccharide capsule ---- in women= gonorrhea can progress to PID, SEPTIC arthritis =======VS======== Meningococci= polysaccharide capsule= VACCINE available => w/o= -Meningiococcemia=> Waterhouse-Friederichsen Syndrome: -Bilateral Adrenal gland hemorrhage -DIC --> Sepsis -No meningitis |
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What gram negative bug can cause similar symptoms to S. pneumonae(MOPS) WITHOUT sinusitis that makes you MOPE around sick?
-Meningitis -Otitis Media -Pneumonia -Epiglottitis |
[-R]=> H. Influenza = DOES NOT CAUSE THE FLU (which is influenza virus)
---------- vaccine is available: 2-8 months ---------- you can treat the meningitis with: Ceftriaxone or if family members have it you can prophylactically treat with Rifampin |
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What part of the [-R] CAPSULE is recognized by our immune system?
----- The only [-R] that has Oxidase is Pseudomonas a. |
[-R] = enterobacteria= Sal/Shi/Prot + E.coli/Klesb=>
----- O= endotoxin k= virulence H= flagella |
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Alcoholics and Diabetics tend to aspirate a lot of stuff into their lungs that causes them to cough up RED CURRANT JELLY from their Pneumonia. What bug is it?
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Klesbiella [-R/L]
------ Also causes UTI while in the hospital |
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What bug causes BLOODY DIARRHEA, enters the circulation because its motile and spreads but requires a lot of them to cause the symptoms?
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[-R/]= Salmonella=>animal contact=> invade intestinal mucosa and gets worse with antibiotic treatment until MONOCYTES come and kill it
=====VS===== Shigella= bloody diarrhea= NOT-MOTILE but more powerful= comes form dirty individuals |
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What bug do you get from a puppy Poo which lives in a DAYCARE CENTER where your KID ate dirty MILK and PORK?
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Yersinia Enterocolitica=> pain similar to Crohn's Disease and FAKE-Appendicitis
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What are some sources of FOOD POISONING?
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-SEAFOOD= Vibro species, Staph a. (fast onset/recovery)
--------- -Custard + Mayo= Staph a. ---------- -Old RICE= Bacillus cereus ------ -Old meat= Clostridium perfringens ------ -Raw meat= E.Coli= O157:H7 ------- -Old cans= Clostridium botulinum ------- -Poultry= Salmonella |
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Which bugs give you a BLOODY DIARRHEA?
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-Campylobacter= loves heat to grow
-C. Difficile -E. Coli (enterohemorrhagic [shigga-like] + Enteroinvasive [invasive to mucosa]) -Entamoeba histolytica = protozoa -Salmonella -Shigella= dysentery -Yersenia =======VS====== WATERY DIARRHEA: -C. perfringens= w/bloated stomach full of gas -E. Coli= Enterotoxigenic= traveler's diarrhea= NO PRE FORMED TOXIN -Vibro Cholera= Rice water diarrhea -Protozoa= Giardia and in AIDS=Cryptosporidium -Virus= RAN= Rota/Adeno/NORWALK |
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What are 2 bugs that are COMMA SHAPED and cause different types of Diarrhea?
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Bloody= Campylobacter= loves heat
---VS----- Watery= Vibro Cholerae ---VS---- 2 commas= N. Gonococci = NO diarrhea though |
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What bugs ACTIVATE cAMP?
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-E. Coli [-R/L] = via ADP-R= permanent on
-Bacillus anthracis [+R] -Bordatella Pertussis [-CR/BG]=blocks Gi= never turns off -Vibrio Cholera= Gs= always on |
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How does Legionella get transmitted?
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water habitat to air:
-grow it with charcoal, Fe++, CYSTEINE and stain it with SILVER -Tx: Erythromycin |
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Which gram NEGATIVE bug has an ENDOtoxin + EXOtoxin?
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Pseudomonas a.
-Endotoxin= fever, shock -Exotoxin= A=blocks EF2 |
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What bug that responds to Aminoglycosides + Piperacillin + Ticarcillin that caused EXTERNAL OTITIS in a swimmer found to releases PYOCYANIN pigment?
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PSEUDOomonas a. = [-R/L] =>
Pneumonia Sepsis UTI External Otitis Diabetic Osteomyelitis |
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What bug is a risk factor for PUD and gastric carcinoma that responds to triple therapy: Bismuth, METRONIDAZOLE, Tetracycline/amoxicillin and creates an ALKALINE environment with its UREASE by making more AMMONIA?
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H. Pylori = [-R/U]
------VS----- Proteus= [-R/U] |
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What bacteria are given to you by TICKS?
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-Lyme Disease= Borellia Burgdorferi= ixodes tick
-Tuleremia= rabbits -----------VS--------------- -Brucella= undulant fever= dairy products or contact with animals -Yersenia pestis= FLEAS from prairie dogs= causes the plague |
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Your young son get bitten by his DOG and CAT and develops cellulitis. What bug is causing this?
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Pasteurella multocida
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What infections can your deer give you?
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Tick= Borrelia burgdorferi= Lyme Disease
Tick= Francisella tularensis= tularemia |
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How do you treat a woman with GREEN vaginal discharge that smells like FISH and is NOT painful but under the microscope you have CLUE cells?
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Gardnerella vaginalis= treat with METRONIDAZOLE
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What is the differential for a + PPD Test?
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1. BCG vaccine
2. Past exposure to TB 3. Current infection ----VS------ -PPD 1. No infection 2. Anergy= current use of steroids, immunocompromised, malnutrition= no Ab response |
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Children that have never had the BCG vaccine and currently present with a Ghon complex in the Hilar nodes of the lower lobes of the lung present with what bug?
Symptoms= FEVER, NIGHT SWEATS, WEIGHT LOSS, vomiting blood |
[AF]=Mycobacterium tuberculosis= Primary TB
------- Depending on your immunological state what can happen: 1. heals= fibrosis 2. Progresses in lungs of immunocompromised (HIV/malnutrition)= but rarely die 3. Severe bacteremia= spreads=Milary TB= DEATH 4. lymphatic spread to organs= dormant tubercle bacilli ===> later in adult life re-activates if immune compromised= -CNS= parenchymal tuberculoma/meningitis -SC= Pott's Disease= curvature/fractures of spine -renal,GI, -LUNGS: secondary TB= FibroCASEOUS filled caviity in APEX of lung |
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What do you call a person with loss of eyebrows, nasal collapse, lumpy earlobes?
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Leonine facies= [AF]=mycobacterium leprae= LOVES cool places like your nose + superficial nerves
------ How do you grow it? YOU CAN'T! ----- Comes from Armadillos in the US ----- Treat with DAPSONE ---- Two types: 1. Lepromatous= REALLY bad because CMI is gone! =die 2. Tuberculoid |
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A man from new mexico who raises armadillos suffers from shortness of breath, bloody urine, anemia=> He has a +PDD and has Mathemoglobinemia + Hemolysis. What is he taking?
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TB and taking Dapsone ===> change over to:
Rifampin + Clofazimine |
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Triad of Headache + Fever + vasculitis-RASH and organism is INTRACELLULAR (needs your NAD and CoA)?
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Rickettsia= anthropod vector = tetracycline
----- Coxiella= airborn and causes pneumonia |
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Rickettsia Vectors= headache, fever, rash
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RSMF= rickettsii= Tick= rash in hands/feet= migrates inward
------VS---- Endemic (regional) typhus= typhi= FLEA= rash spreads OUT to limbs ------VS----- Epidemic(global) typhus= prowasakkii= Body lice= rash spreads INwards ==========VS======= Q fever=Coxiella burnetti= inhaled= can live outside for a long time= no Weil-Felix test result=NO RASH=NO VECTOR |
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What is the differential for a rash in your palms and soles?
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1. RSMF= east coast intracellular bug
2. Syphilis= secondary 3. Coxsackievirus A= hand-foot-mouth disease |
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What does a POSITIVE Weil-Felix reaction indicate in someone suffering from headaches, fever, rash?
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RSMF + typhus NOT for Q-fever
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military recruits and prisoners develop PNEUMONIA very slowly, np-cough, and CXR looks REALLY bad but not the patient. What type of titer will this patient have and where would you grow it?
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high titer of IgM and grow it in: Eaton's agar:
-------- Mycoplasma Pneumoniae= NO CELL WALL w/ Cholesterol membrane ==> Penicillin will NOT work= use Tetracycline |
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Describe the life cycle of Chlamydiae?
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Enters host cell= elementary body
Inside= forms Reticulate body and divides via FISSION = forms cytoplasmic inclusion Inside cytoplasmic inclusion= changes into Elementary Body => BURSTS open= re-infects ======== Test= Giemsa + ELISA= cytoplasmic inclusions ======== wall has NO MURAMIC ACID = allows it to target mucosal sufaces |
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What type of Chlamydia exist?
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trichomatis= reactive arthritis/urethritis(non-gonococcal)/conjunctivitis
---------- pneumoniae/psittaci= air=pneumonia ----- TX; erythromycin |
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How do the different Serotypes of Chlamydiae present?
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ABC= African Blindness, Chronic infection
------ D-K: urethritis (PID)--> ectopic pregnancies--> neonatal pneumonia/conjuctivitis(erythromycin eye drops) ----- L1,2,3= swollen lymphnodes in groin area= lymphogranulomas= + Frei Test ------ Small Chlamydiae has no peptidoglycan wall= cannot respond to peniciilin= often asymptomatic cause of urethritis/PID= cause of infertility |
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Only Spirochete visualized through Wright's or GIEMSA stains?
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Borellia Burgdorferi= ixodus= BULL'S EYE rash that spreads in summer montsh in New England area=> huge compared to other spirochetes:
------------ Leptospira, Treponema (only via Darkfield microscopy) |
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What are the 3 stages of Lyme Disease which respond to Tetracycline?
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1= erythema chronicum migrans + Flu,
2= neurologic (Bell's Palsy) + heart problems (AV block/palpitations), 3= Autoimmune: arthritis =hot, swollen, painful joints spreads throughout body and neurological damage |
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If you fail to grow gonorrhea in a patient persistant dysurea what is the default daignosis?
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Non-Gonococcal Urethritis;
1. Chlamydia 2. Ureaplasma urealyticum |
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What happens when a newborn is born with Treponema Pallidum=Spirochete=> Syphilis?
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Saber chins, saddle nose, DEAF
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Painless chancre + highly sexually active teen?
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Primary Syphilus
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Rash in palms/soles + previous history of painless chancre + highly sexually active?
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Secondary Syphilus
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Previous history of painless chancre years ago + Gummas + aortitis + tabes dorsalis signs(no vibration/propioception) + Argyll Robertson pupil (accomodates but is NOT reactive to light)?
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Tertiary Syphilus= Positive Romber's sign(UMN deficit= Tabes Dorsalis), ataxia, strokes in the absence of HTN! ===
Treat with Penicillin G |
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How would you test for Syphilus?
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FTA-ABS + VDRL= both positive indicates that disease is ACTIVE
-----VS----- negative VDRL and positve FTA= successfully treated -------------- FTA-ABS: more specific, widespectrum detection, |
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What is the differential diagnosis for a positive VDRL= cardiolipin-ab?
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1. Virus (mononucleosis, hepatitis)
2. Drugs 3. Rheumatoid Arthirits 4. Rhuematic fever 5. SLE 6. Leprosy |
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What type of FUNGAL spore is INHALED in a asexual phase?
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coccidioidomycosis + histoplasmosis
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What type of individual gets Candida Albican infection in the esophagus which requires Nystatin mouth wash?
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Immunocompromised individuals=
-neonates -steroid use -Diabetes -AIDS -------- Candidiasis= budding yeast with pseudohyphae at 20*C but forms tubes at higher temperatures |
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What FUNGAL infection does an IV drug user get in his heart?
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Endocarditis from Candida Albicans= treat with Amphotericin B
------ Following antibiotic treatment women tend to get vaginits ------ Cause of Diaper Rash |
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Certain fungal infections are endemic+ SYSTEMIC to certain regions. All which are Dimorphic= at low temperatures they are MOLDS but in the warm body=YEAST
***Coccidioidomycosis= spherule in tissue full of endospores***** |
Coccidioidomycosis=inhaled= SW USA=> sphere full of spores that are inhaled=> San Juaquin Valley Fever
---------VS------- PARAcoccidioidomycosis= rural latin america= looks like a captain's wheel -------- Histoplasmosis= along the Mississippi river=Ohio=> Bird-Bat/poop=> inhaled= goes inside your macrophages ---------VS----- Blastomycosis= East Coast Basin+ Mexico=> Big, Broad, Budding |
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What are some CUTANEOUS mycoses and their associated features?
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Tinea Versicolor= HYPOpigmentation=micanozole
Tinea nigra= Cladosporium werneckii= brown spots =salicylic acid Tinea pedis=Trichophyton=itchy=circular=NOT dimorphic |
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What is a MOLD that is NOT Dimorphic and branches at acute angles and form a FUNGUS BALL?
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Lung Cavity= Aspergilloma => Aspergillus fumigatus
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Name the NON-DIMORPHIC fungus that can be grown on Sabouraud's agar, stained with INDIA INK and a LATEX AGGLUTINATION of the polysaccharide capsule detects it?
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Cryptococcus neofromans = > Cryptococcal meningitis= heavily encapsulated yeast= looks like a white halo on india ink
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Which fungal infection can cause Rhinocerebral + Frontal Lobe abscess in Diabetics Type I and Luekemic patients?
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Mucormycosis=> MOLD= irregular + non-septate, wide angles
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What INFECTIOUS and ASYMPTOMATIC Yeast must be treated with: TMP-SMX + Dapsone + Pentamidine as CD4+ counts fall below 200?
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Pneumocystis carinii= inhaled= attacks Lungs in AIDS patients=> diagnose via lavage or lung biopsy followed by SILVER STAIN
----------- (also works with fungus, legionella) |
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A gardener pokes himself in the finger with a rose and then develops a row of ulcers along the arm (lymphatic drainage). What type of treatment will work for this man?
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Spirothrix schenckii= DImorphic Fungus=> unequal budding=> TX: Itraconazole + KI
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Individual comes in with bloody diarrhea, a palpable liver abscess and RUQ and responds to Metronidazole/Iodoquinol after serology is positive and TROPHOZOITS are found in stool?
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Entamoeba histolytica= get it from Cyst in water
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Hiker comes in with BLOATING, FLATULENCE, and really bad smelling Poop while eating a pear. TROPHOZOITS are found in stool and responded well to Metronidazole?
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Giardia lamblia= get it from cyst in the water => looks like a PEAR with 2 nuclei
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AIDS patients comes in with REALLY bad diarrhea and his partner without HIV has a watery but milder diarrhea attack. BOTH showed CYST on Acid FAST stain. No treatment was given?
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Cryptosporidium= got it from Cyst in gay WATER baths in SF
----VS---- Not to be confused with Crytpococcus neoformans which is a fungal infection from PIGEON poop. |
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An HIV patient who has tons of cat feces in her hands is diagnosed with a Brain abscess and her newborn has RING ENHANCING lesions. Biopsy confirmed. Treatment?
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SulfaDIAZine + Pyrimethamine for TOXOPLASMA
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What is the treatment for an Afrikan man who has CYCLIC FEVERS, headaches, anemia and spleenomegaly and tons of Anopheles mosquito bites?
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Malaria (vivax, ovale, malariae, falciparum=WORST) =>
-Primaquine= prevents flair ups due to ovale/vivax -SulfaDOXine -Pyramethamine -Mefloquine -Quinine |
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Histrionic Woman with FOUL smelling, green sometimes gray discharge from her vagina. She complains of BURNING and ITCHING while turning Trichs in the corner. Wet mount shows MOTILE TROPHOZOITS. What is the treatment?
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Metronidazole for TRICHOMONAS vaginalis
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BRAZILIAN man presents with a dilated heart, giant colon, and a giant esophagus and admits that he was bitten by his pet Reduviid Bug. How would you treat him?
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NifurtiMOX for Trypanosoma Cruzi
-----VS------- gambiens + rhodesiense = African sleeping sickness transmitted via the Testes fly ==>Tx: Suramin= blood Melarsoprol= CNS |
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A SANDFLY shits in your arm and then AMASTIGOTES are found INSIDE your macrophages from aspirates from your LIVER,SPLEEN, BM. How would you treat this #2 world wide killer?
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Sodium stibogluconate after K39 Dipstick is positive for; Leishmania Donavani
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The IXODES tick also carries this protozoal bug in addition to Borrelia burgdorferi (lyme disease) but this one presents with a MALTESE CROSS on blood smear and causes FEVER + ANMEIA. How would you treat it?
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Quinine and Clindamycine for the BABESIA slut
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A FRESH WATER naegro-swimmer dies RAPIDLY from MENINGOENCEPHALITIS. On biopsy the spinal fluid is FULL of AMEBAS which entered via the CRIBRIFORM PLATE in your nose. What protozoal bug is it?
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Naegleria
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What are two tapeworms or cestodes that commonly affect humans?
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1. Taenia solium= undercooked pork 2. Echinococcus granulosus = dog poop contains eggs
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Why does consumption of DOG poop cause anaphylaxis in a child?
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CYST in LIVER= Echinococcal antigens are released from the eggs of Echinococcus granulosum= quickly treat with Albendazole
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Eating undercooked PORK can predispose you to what tapeworm that causes multiple cysts in your brain?
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Taenia solium=> SEIZURES= causes Cysticercosis= treat that with Albendazole and also Praziquantel/niclosamine
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There are 3 types of FLUKES that you can get at a sushi restaurant. All treatable with Praziquantel.
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1. SNAILS: crawl to you feet and penetrate your skin--> go into your LIVER + SPLEEN and cause inflamation, granulomas and fibrosis:portal hypertension= SCHISTOSOMA
------------------------ 2. FISH: go up into your BILIARY TREE and cause inflammation: CHLONORCHIS sinensis, --------------------- 3. CRAB: causes inflammation and secondary baterial infection of your LUNG= Hemoptysis=PARAGONIMUS westermani |
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Which Shistosoma can cause BLADDER CANCER?
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Schitosoma HAEMATOBIUM= makes you bleed in your urine
-------VS------- MANSONI which causes liver fibrosis |
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Which two Helmiths respond to Ivermectin?
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1. Strongyloides
2. Onchocera |
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Brain cyst + seizures
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Taenia Solium
----VS----- Cyst in liver= Echinococcus granulosus |
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Helminths + B12 deficiency=
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Diphyllobothrium latum
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Helminths + Jaundice=
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Clonorchis sinensis= Biliary tract disease
-----VS----- Portal hypertension= Schistosoma |
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Helminth + Hemoptysis
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Paragonium
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Which is the only DNA Virus that is NOT double stranded?
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Parvo virus
-----VS----- the only DNA virus that is circular= Hepadnavirus |
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What is the only RNA virus that is NOT single stranded?
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Reo virus
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A virus that has no envelope and is + are INFECTIOUS:
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most DNA= NOT Pox + HBV + Parvo + Hepadna
-------VS----- RNA= only + ssRNA= mRNA= Calicivirus + Picornovirus + Reovirus ------------- most require special enzymes to be translated first |
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Which is the only virus that aquires their ENVELOPE not from the plasma membrane BUT from the NUCLEAR membrane?
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Herpes virus
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Which is the only virus that is DIPLOID and has 2 ssRNA's?
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RETROvirus
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Pox virus is neither infectious nor does it replicate in the _______like most DNA viruses because it has its own DNA-dependant RNA polymerase.
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nucleus
--------VS-------- RNA viruses replicate in the cytoplasm excpet: Influenza + Retro |
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What 2 RNA viruses, enveloped, Helical capsid cause Hemorrhagic Fevers?
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1. Filovirus= Ebola
2. Bunya= Hanta + Crimean Congo |
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What 2 RNA viruses, NOT enveloped, icosahedral capsid cause aseptic meningitis= not infectious irritation of the meninges?
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Picorno=
1. Echo 2. Coxsackie |
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What is the origin of the 3 Hepatitis viruses?
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HAV= RNA= Picorno
HBV= DNA= Hapadna HCV=RNA=Flavi HDV=RNA= Delta HEV= RNA=Calci |
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What are the sugars that allow you to identify the various RNA, enveloped, helical viruses of the Paramyxovirus?
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HN=Parainfluenza
HN= Mumps H= Measles G=RSV |
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DNA/RNA virus acronym
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HHAPPP = DNA
------VS---------- PCR FTR COP FAB DR = RNA |
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Why is it dangerous to give LIVE vaccines to immunocompromised individuals?
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LIVE= Humoral + CMI = might revert back
---------VS-------- KILLED= only Humoral= stable |
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LIVE Vaccines include=
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RNA=>
-MMR -Polio= Sabin=oral -Yellow Fever= Flavi ------VS----- DNA=> -VZV -Adeno -Small pox |
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KILLED Vaccines include=
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RISH=>
-Rabies -Influenza -Salk=Polio=IV -HAV ---------VS----- Recombinant= HbsAg= HBV |
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How many segments does the RNA, enveloped, helical, negative strand ORTHOMYXOvirus have?
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8 segments= can undergo REASSORTMENT(high frequency) that causes ANTIGENIC shifts that lead to EPIDEMIC flu around the world.
-------- other segmented virus= BOAR Bunya, Orthomyxo, Arena, Reo |
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Which virus in a PHENOTYPIC MIXING determines infectivity?
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A inside B coat = B coat rules
----BUT----- A/B progeny will have A coat |
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What Kids Paramyxovirus (enveloped, negative strand, Helical envelope) causes Bronchiolitis + pneumonia in babies?
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RSV
----- only paramyxovirus with more than 1 serotype is: parainfluenza= croup= 4 serotypes |
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What Paramyxovirus makes your Parotid glands and your balls BIG and possibly sterile later on in life !!!
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Mumps and you get Meningitis
------VS----- Measles= Koplik spots= blue-grey spots inside you mouth= also rash all over your body==> bad immune system can cause= GIANT cell pneumonia = Cough, Coryza, Conjuctivitis |
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What RNA virus much like DNA virus VZV can retrogradely go up neurons and cause a FATAL ENCEPHALITIS + SEIZURES + HYDROPHOBIA after a Skunk or raccoon bites you?
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Rabies virus= BULLET SHAPED capsid
------ 3 month incubation period |
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Which fevers are transmitted by bites?
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Arthropods Bites=
Flavi= -dengue= break-your-bones FEVER -Yellow= Aedes Mosquito= Black Vomit + Jaundice (councilman bodies=acidophilic inclusions in liver) + HIGH FEVER -------- Toga= Rubella Bunya= hanta |
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Neonatal herpes is more commonly associated with what Herpes virus?
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HSV-2= via the mothers vagina
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What is the VZV also cause besides shingles?
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encephalitis + pneumonia
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Which Herpes serotype can be transmitted via URINE, CONGENITAL, SALIVA, and TRANSPLANTS?
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CMV= mono=NEGATIVE monospot test
-----VS------- EBV= infects B cells=> infectious mono (saliva)=> POSITIVE monospot test = Heterophil Ab's against EBV when mixed with Sheep blood== agglutination (positive) -------------- Mono= large lymphnodes (B-cells multiply)=posterior auricular nodes + fever, chills, night sweats, and PAINFUL pharyngitis + Atypical lymphocytes (cytotoxic T cells circulate) -------- Spleenomegaly= dangerous if you fall and rupture it |
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What is the differential for a POSITIVE TZANCK TEST from an open skin vesicle?
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Tests for MULTI-NUCLEATED GIANT CELLS ==>
1. HSV 1/2 2. VZV |
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What viruses have Reverse Transcriptase?
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HBV= DNA||DNA pol
------------- Pox= DNA||RNA pol =========== HIV= RNA||DNA pol |
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Which RNA virus requires a DNA derived coat in order to be functional?
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RNA=Delta=HDV needs DNA=Hepadna=HBV= HBsAg as its envelope
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Which Hepatitis virus is transmitted through the water and causes mortality in pregnant women infected?
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RNA=Calci=HEV
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Which 2 virus that target the liver are risk factors for Hepatocellular carcinoma?
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DNA=Hepadna=HBV
RNA=Flavi=HCV |
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What does a HBsAg mean?
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Surface protein of virus=
-continued presence= CARRIER state -----VS-------- -Ab against HBs= immunity= after 6 months from infection |
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What type of antibody presents with a high titer against HAV?
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IgM = active
------ remember that IgM= acute vs IgG= chronic/recovered |
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How do you know if a certain HBV infection is recent or old?
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HBc Antibodies=
IgM= recent ---vs---- IgG=old |
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How can you tell whether a person with a positive IgM-HBc is infectious or not?
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Infectious= HBeAg => lasts about 2 months
----VS---- NOT infectious= HBe-Ab |
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How can you tell where in the infectious life cycle of HBV you are at?
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1. Incubation period= HBsAg
2. Prodrome=acute stage= HBsAg + HBc-Ab 3. Convalescence= Recovery= -Early=full recovery= HBc- Ab -Late= chronic= HBs and HBc Antibodies |
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What are the different components of the HIV virus?
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Inside capsid=
-2 molecules of RNA= code for Protease + Intergrase -RNA||DNA polymerase ------------------ Capsid markers= p24 ----------------- Envelope markers= gp41 + gp120 |
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What is the order of test that must be done to Diagnose HIV?
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First you want to RULE OUT HIV= get a very SENSITIVE test like--> ELISA = has a high FALSE POSITIVE rate= so if its negative then it really is negative
-------------- If ELISA is positive then choose a very SPECIFIC TEST= Western Blot=> Has a HIGH FALSE NEGATIVE rate so if its really positive then it really is positive ------------- |
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Why should you be skeptical about a POSITIVE (ELISA/Western Blot) in a newborn from an HIV+ mother?
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These tests are overtly sensitive= Highly false positive rate because the Ag that the test pick up CROSS the placenta=>
gp120-Ab --------vs----------- High false negatives in the first 2 months of the infection in ADULTS --------- PCR can be used to assess viral load and therapy effectiveness Diagnosis of AIDS= <200 CD4+ -----vs----- Indicators of AIDS= *Pneumocystis carinii *CD4+/CD8+= LOW |
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What mutation causes a RAPID progression to AIDS in a HIV+ patient?
|
CXCR1
------vs------ Slower onset to AIDS= heterozygous for CCR5 ---vs---- Full immunity=homozygous= CCR5 -homo= CCR5= 1% of white population |
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the time course of HIC progresses from Acute --> Latent --> immunodeficient. At that point what drops and what rises with CD4+ counts?
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-CD4+ and Ab: p24, gp120 also drop
-p24 antigen rises= means virus # are increasing |
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What does a MICROGLIA nodule with multi-nucleated giant cell indicate in an AIDS patient?
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HIV encephalitis= occurs late
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What makes a PRION disease so deadly= rapid progressive dementia?
|
normal alpha-helix is transformed into Beta-pleated sheets in the brain
***** infectious agents that do not contain DNA/RNA |
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Meningitis is most commonly caused by what?
|
Newborn= GBS
Infant= Streptococcus pneumoniae Elderly= S. pneumonia -----VS---- everyone else= N. Meningitidis |
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How can you distinguish between meningitis of Fungal and TB origin VS bacterial
|
Both= increase CSF protein + decrease glucose
TB/fungal= Lymphocytes -----VS----- Bacterial= PMN's ======== viral= no protein and no sugar usage |
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What is the most common cause of Osteomyelitis in an individual with Sickle Cell Anemia?
|
Salmonella
----VS----- normal= mostly kids= Staph. a ---------- Pott's Disease= TB in vertebral system ----VS----- Diabetics= pseudomonas a. |
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What is the most common cause of a UTI in a diabetic woman who just had kidney surgery?
|
E. Coli> Proteus>Klesbiella
----VS----- Ambulatory: teen girl E.Coli> Staph. saprophyticus ------ E.coli= EMB agar= metallic scheen ------ |
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What would you use to test for a UTI?
|
Leukocyte Esterase= positive= bacterial
----> followed by: Nitrite Test= positive= Gram negative |
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What are two STD's that affect the vagina?
|
Trichomonas vaginalis= strawberry colored mucosa= vaginitis
----VS----- Gardenella vaginalis= smelly, fishlike discharge= CLUE cells, + whiff test ----VS----- Gonorrhea= White/creamy discharge = urethritis, cervicitis, arthritis |
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What type of ulcers can a penis get?
|
PainLESS= 1* Syphilis
---VS---- Painful= 1. Genital herpes 2. Chancroid (haemophilus ducreyi) + inguinal lymphnodes are big |
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What is the difference between Conylomata lata and Condylomata acuminata?
|
Condylomata lata= 2* Syphilis = infectious and white on genitals
---vs----- Condylomata acuminata= HPV 6/11= warts on genitals = infectious= cause cervical cancer |
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What is Reiter's Syndrome and what STD is this linked too?
|
1. Inflammatory arthritis
2. Conjuctivitis 3. Urethritis ---- manifestation of Chlamydia -----VS---- L1,2,3 serotype= -ulcers -lymphnode swellings -RECTAL STRICTURES |
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What do Koilocytes predispose you too?
|
-large nucleus + hyperchromatin=> Precancerous
-found with Condylomata acuminata= HPV |
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What is PID (chlamydia[asymptomatic] or gonorrhea[acute pain]) derived SALPINGITIS (inflammation of the fallopian tubes) a risk factor for?
|
-ectopic pregnancy
-infertility -chronic pelvic pain -adhesions |
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|
What are the most dangerous infections of pregnancy?
|
TRCHS
=Toxoplasmosis =Rubella =CMV =HSV + HIV -Syphilis |
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Hookworms= Necator + Ancylostoma=penetrate skin --> lungs--> cause Eosinophilic Pneumonia=> enter alveoli and are swallowed:
|
Eats your Iron= microcytic anemia
---- PICA people eat soil contaminated with infectious larvae |
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What toxin paralyses the villi and causes necrosis of the bowel wall=> death after bowel rupture and shock?
|
raw meat=> Clostridium Perfringens= Toxin B causes paralysis
---- alot of air bubbles in XR ----- used for home-abortion = endometritis |
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Does H.Pylori grow on Duodenal mucosa and does it breach the epithelial barrier?
|
NO
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|
What is the evidence for Hemochromatosis?
|
Hyperglycemia + Hyperbilirubinemia + increase Fe++ in serum (or Transferritin)
---------- causes chronic liver disease + vibrio vulnificus from seafood causes septicemia with a nasty skin lesions |
|
|
What are some causes of blindness in AIDS patients?
|
-CMV retinitis= treatable=acyclovir resistant
-Toxoplasmosis -PML |
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|
Which Protozoan infections can be identified via CSF which both cause Meningoencephalitis?
|
find spiky trophozites= Acanthamoeba=>contact lens solution= keratitis
------VS------- find amebas= Neagleria fowleri= freshwater lakes= death in 6 days |
